{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:58:04Z","timestamp":1792421884196,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the effects of an oral nutritional supplement (ONS) enriched with hydroxy\u2010methyl\u2010butyrate (HMB) in subjects with disease\u2010related malnutrition (DRM) and to monitor these effects with an ultrasound Imaging System, based on artificial intelligence, in a real\u2010world study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty consecutive adult patients with DRM were enrolled. The malnutrition was diagnosed by Global Leadership Initiative on Malnutrition (GLIM) criteria. For 3\u2009months, the patients received nutritional education, and medical nutrition therapy was started with an adapted oral diet and two servings of an oral nutritional supplementation (ONS) with a hyperproteic hypercaloric formula (HMB\u2014enriched). All patients were studied at baseline, and 3\u2009months after intervention, with a nutritional assessment (anthropometry, bioelectrical impedanciometry [BIA], muscle ultrasonography and biochemical parameters). Ultrasound images were automatically quantified using an AI\u2010based ultrasound imaging system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 50 patients (21 men and 29 women) with a mean age of 57.8\u2009\u00b1\u200918.1\u2009years. Following treatment with the HMB\u2010enriched ONS, the prevalence of sarcopenia decreased significantly (from 24% to 18%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and severe malnutrition (from 14% to 2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). An improvement in BIA parameters; phase angle (0.14\u2009\u00b1\u20090.02\u00b0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02); phase angle index (0.07\u2009\u00b1\u20090.01\u00b0\/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01); fat free mass (1.31\u2009\u00b1\u20090.12\u2009kg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006); skeletal muscle mass (0.51\u2009\u00b1\u20090.11\u2009kg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01); and skeletal muscle mass index (0.31\u2009\u00b1\u20090.13\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) were reported. Functional parameters as handgrip strength (1.36\u2009\u00b1\u20090.21\u2009kg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and seconds of time up and go test (1.16\u2009\u00b1\u20090.15\u2009s;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) showed also an improvement. The AI\u2010based ultrasound system detected a significant increase in the thickness of the vastus intermedius muscle (TVI) (0.09\u2009\u00b1\u20090.01\u2009cm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and an increase of the rectus femoris (TRF) (1.06\u2009\u00b1\u20090.4\u2009cm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07) with the consequence of a significant increase of the (TVITRF) (0.15\u2009\u00b1\u20090.02\u2009cm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). The sarcopenia index is also significant (1.03\u2009\u00b1\u20090.3\u2009cm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Muscle quality, as assessed by echogenicity analysis, improved significantly: muscle index (Mi) (0.04\u2009\u00b1\u20090.01;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and (fat index) FATi (\u22120.03\u2009\u00b1\u20090.01;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of an HMB\u2010enriched ONS in DRM patients, combined with AI\u2010based ultrasound imaging for follow\u2010up, significantly improved their nutritional status, muscle mass and muscle quality as assessed by echogenicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13700","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:42:25Z","timestamp":1740530545000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of Hydroxy\u2010Methyl\u2010Butyrate Supplementation on Malnourished Patients Assessed Using AI\u2010Enhanced Ultrasound Imaging"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1745-9315","authenticated-orcid":false,"given":"Daniel","family":"de Luis","sequence":"first","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda, Nutrici\u00f3n Facultad de Medicina, Departamento de Endocrinolog\u00eda Nutrici\u00f3n Hospital Cl\u00ednico Universitario de Valladolid  Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Cebria","sequence":"additional","affiliation":[{"name":"DAWAKO Medtech SL Parc Cient\u00ecfic de la Universitat de Valencia  Paterna Valencia Spain"},{"name":"T\u00e9cnicas Avanzadas de Desarrollo de Software Centrado en la Persona, Departamento de Inform\u00e1tica Universitat de Valencia  Burjassot Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Primo","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda, Nutrici\u00f3n Facultad de Medicina, Departamento de Endocrinolog\u00eda Nutrici\u00f3n Hospital Cl\u00ednico Universitario de Valladolid  Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Nozal","sequence":"additional","affiliation":[{"name":"DAWAKO Medtech SL Parc Cient\u00ecfic de la Universitat de Valencia  Paterna Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olatz","family":"Izaola","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda, Nutrici\u00f3n Facultad de Medicina, Departamento de Endocrinolog\u00eda Nutrici\u00f3n Hospital Cl\u00ednico Universitario de Valladolid  Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo\u00a0Jorge","family":"Godoy","sequence":"additional","affiliation":[{"name":"DAWAKO Medtech SL Parc Cient\u00ecfic de la Universitat de Valencia  Paterna Valencia Spain"},{"name":"T\u00e9cnicas Avanzadas de Desarrollo de Software Centrado en la Persona, Departamento de Inform\u00e1tica Universitat de Valencia  Burjassot Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan\u00a0Jose","family":"Lopez\u00a0Gomez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda, Nutrici\u00f3n Facultad de Medicina, Departamento de Endocrinolog\u00eda Nutrici\u00f3n Hospital Cl\u00ednico Universitario de Valladolid  Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.05.024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14071524"},{"key":"e_1_2_9_4_1","first-page":"202","article-title":"Effect on Quality of Life and Handgrip Strength by Dynamometry of an Enteral Specific Suplements With Beta\u2010Hydroxy\u2010Beta\u2010Methylbutyrate and Vitamin d in Elderly Patients","volume":"32","author":"Luis D. 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